目的 评价香蕉皮缝合模型在口腔医学专业实习学生缝合教学中的应用效果。方法 2021年1月至3月,以北京大学2017级口腔医学专业82名实习学生为研究对象,使用香蕉皮作为缝合模型进行缝合练习。记录课堂讲解前缝合评分(基线水平),对课堂讲解后(训练1)和课下练习后(训练2)缝合结果进行评分。使用配对t检验比较每次训练评分,使用Pearson相关分析检验评分的相关因素。结果 训练1评分[(20.88±3.68)分]高于基线水平[(15.15±5.24)分],训练2评分[(24.80±3.83)分]高于训练1评分,其差异均具有统计学意义(均P＜0.05)。训练1评分与全学程成绩相关(r=0.29);训练2评分与性别(r=0.39)、课下练习累计时长(r=0.44)、全学程成绩相关(r=0.29),其差异均具有统计学意义(均P＜0.05)。结论 在课堂教学和课下练习中应用香蕉皮缝合模型,可以有效提高口腔医学专业实习学生学生的缝合水平。
Objective To evaluate the effect of the suture training for internship students majoring in stomatology using the banana peel model. Methods From January to March 2021, Eighty-two students in Peking University School and Hospital of Stomatology were trained in their pre-clinical year and then followed by a workshop on surgical suture. Banana peels were used as a suturing model. The baseline scores were recorded. The suturing skills were assessed after instruction (training 1) and after-class practicing (training 2). Paired t-test was used to compare the results. Pearson's correlation was used to analyze the relevant factors. Results The score of training 1 (20.88±3.68) was higher than that of baseline level (15.15±5.24) and the score of training 2 (24.80±3.83) was significantly higher than that of training 1 (20.88±3.68), all P<0.05. The score of training 1 is related to the scores of the whole course (r=0.29). Training 2 results are related to gender (r=0.39), cumulative time of after-class exercises (r=0.44) and the whole course scores (r=0.29), all P<0.05. Conclusions The suturing skill of students was significantly improved after training with banana peel model. This provides a solid evidence to support the use of this model for suturing skill training.
[1] 邱蔚六.口腔颌面-头颈外科手术学[M].合肥:安徽科学技术出版社, 2014:20-21.
[2] Lee KS, Priest S, Wellington JJ, et al. Surgical skills day: bridging the gap[J].Cureus,2020,12(5):e8131. DOI:10.7759/cureus.8131.
[3] Manning EP, Mishall PL, Weidmann MD, et al. Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: suturing during cadaver dissection[J]. Anat Sci Educ, 2018,11(6):605-612. DOI:10.1002/ase.1785.
[4] Boyajian MK, Lubner RJ, Roussel LO, et al. A 3D printed suturing trainer for medical students[J]. Clin Teach, 2020,17(6):650-654. DOI:10.1111/tct.13176.
[5] 安娜, 欧阳翔英, 康军, 等. 牙周病学前期实习教学中牙周手术缝合模型的建立与应用[J].中华医学教育杂志,2014,34(6):881-883. DOI:10.3760/cma.j.issn.1673-677X.2014.06.026.
[6] Gonzalez-Navarro AR, Quiroga-Garza A, Acosta-Luna AS, et al. Comparison of suturing models: the effect on perception of basic surgical skills[J]. BMC Med Educ, 2021,21(1):250. DOI:10.1186/s12909-021-02692-x.
[7] Schwartz CM, Ivancic RJ, McDermott SM, et al. Designing a low-cost thyroid ultrasound phantom for medical student education[J]. Ultrasound Med Biol, 2020,46(6):1545-1550. DOI:10.1016/j.ultrasmedbio.2020.01.033.
[8] Zambricki EA, Bergeron JL, DiRenzo EE, et al. Phonomicrosurgery simulation: a low-cost teaching model using easily accessible materials[J]. Laryngoscope, 2016,126(11):2528-2533. DOI:10.1002/lary.25940.
[9] Wong K, Bhama PK, d'Amour Mazimpaka J, et al. Banana fruit: an “appealing” alternative for practicing suture techniques in resource-limited settings[J]. Am J Otolaryngol, 2018,39(5):582-584. DOI:10.1016/j.amjoto.2018.06.021.
[10] Chua W, Kong CH, Murphy DP. Male orthopaedic surgeons and anaesthetists: equally good at estimating fluid volumes (and changing light bulbs) but equally poor at estimating procedure duration[J]. Singapore Med J, 2015,56(5):264-267. DOI:10.11622/smedj.2015076.
[11] Wallace D, Sturrock A, Gishen F. ‘You've got mail!’: clinical and practical skills teaching re-imagined during COVID-19[J]. Future Healthc J, 2021,8(1):e50-e53. DOI:10.7861/fhj.2020-0231.
[12] Wongkietkachorn A, Rhunsiri P, Boonyawong P, et al. Tutoring trainees to suture: an alternative method for learning how to suture and a way to compensate for a lack of suturing cases[J]. J Surg Educ, 2016,73(3):524-528. DOI:10.1016/j.jsurg.2015.12.004.
[13] Routt E, Mansouri Y, de Moll EH, et al. Teaching the simple suture to medical students for long-term retention of skill[J]. JAMA Dermatol, 2015,151(7):761-765. DOI:10.1001/jamadermatol.2015.118.
[14] Davis CR, Toll EC, Bates AS, et al. Surgical and procedural skills training at medical school - a national review[J]. Int J Surg, 2014,12(8):877-882. DOI:10.1016/j.ijsu.2014.05.069.
[15] Tallentire VR, Smith SE, Wylde K, et al. Are medical graduates ready to face the challenges of Foundation training?[J]. Postgrad Med J, 2011,87(1031):590-595. DOI:10.1136/pgmj.2010.115659.
[16] Matheson C, Matheson D. How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitals[J]. Postgrad Med J, 2009,85(1009):582-589. DOI:10.1136/pgmj.2008.071639.
[17] Moulton CA, Dubrowski A, Macrae H, et al. Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial[J]. Ann Surg, 2006,244(3):400-409. DOI:10.1097/01.sla.0000234808.85789.6a.
[18] Bekele A, Wondimu S, Firdu N, et al. Trends in retention and decay of basic surgical skills: evidence from Addis Ababa University, Ethiopia: a prospective case-control cohort study[J]. World J Surg, 2019,43(1):9-15. DOI:10.1007/s00268-018-4752-1.
[19] Martin JA, Regehr G, Reznick R, et al. Objective structured assessment of technical skill (OSATS) for surgical residents[J]. Br J Surg, 1997,84(2):273-278. DOI:10.1046/j.1365-2168.1997.02502.x.
